Provider Demographics
NPI:1821358763
Name:JEFFREY HENKES DDS, PLLC
Entity Type:Organization
Organization Name:JEFFREY HENKES DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:HENKES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-999-7858
Mailing Address - Street 1:15600 NE 173RD ST
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-8986
Mailing Address - Country:US
Mailing Address - Phone:425-999-7858
Mailing Address - Fax:
Practice Address - Street 1:22725 44TH AVE W
Practice Address - Street 2:SUITE 100
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-4500
Practice Address - Country:US
Practice Address - Phone:425-999-7858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000072661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty